study of serum zinc levels among patients of coronary artery disease conducted in a tertiary care hospital

Zinc is an important trace element that has been increasingly implicated in coronary artery disease. The study was designed to compare serum zinc levels in patients of coronary artery disease and healthy controls. It was a prospective, case control study. A total of 125 male participants were divided into healthy controls [n = 25], Ischeamic subjects without myocardial infarction [n = 50], and Ischaemic subjects with previous or present infarction [n = 50] were included in the study. The serum zinc was analysed by atomic absorption spectrophotometery. The mean age in the ischaemic heart disease patients without infarction [Group - A] and with infarction was comparable to the mean age of control group. Family history of ischaemic heart disease and history of smoking were more common among disease groups as compared to controls. Serum zinc levels were found to be significantly low in study sub-group B[2] [83.68 +/- 5.55 micro g/dl] as compared to control group [99.16 +/- 5.18 micro g/dl] and remaining study groups showed insignificant differences. Decreased serum zinc levels are associated with coronary artery disease especially the acute myocardial infarction

Surgery for pleuropulmonary tuberculosis

The purpose of our study was to analyze current indications for surgery in pleuropulmonary tuberculosis [TB]. We present our experience with TB patients presenting with indications for surgery between 1998 and 2003. Material and The indications for surgical intervention included 220 cases of empyema, mediastinal lymphadenopathy 48 cases, hemoptysis 25 cases, destroyed lung 24 cases, undiagnosed pleural effusion 24 cases, bronchiectasis 18 cases, cavitary lesion with MDRTB 13 cases and pulmonary aspergilloma 10 cases. Thirteen patients with multidrug-resistant tuberculosis required surgical intervention, although 26 were treated with second line drugs during this period. The techniques utilized included decortication in 152 cases, lobectomy in 62 cases, rib resection for pleural drainage in 50 cases, anterior mediastinotomy in 48 cases, pneumonectomy in 28 cases, open pleural biopsy in 24 cases, and thoracoplasty in 18 cases. In 12 patients [3.1%], two procedures were performed, and in one case, 3 procedures. In 65 cases [17%] there were complications, of which persistent air leakage after decortication and pulmonary resection was the most frequent [n=26]. There was a mortality rate of 2.8% [11 cases]. Conclusions: In our experience, surgery in the treatment of TB is indicated to resolve sequalae or complications, since cases of simple or multidrug-resistant TB can be managed pharmacologically. The morbidity and mortality rates in our series were acceptable

Rectal barotrauma causing colonic perforation: a rare case report

A rare case of intestinal perforation following air insufflation into the anus through the nozzle of a compressed air pipe is presented. The literature on the subject is reviewed. The workers handling compressed air should be made aware of the potential dangers to minimize such accidents in the future

Neonatal tetanus in Pakistan

Tetanus is caused by the spore forming gram positive, anaerobic organism clostridium tetani. It is a well known killer in neonates. In Islamabad this disease is especially seen in its Katchi Abadis. Over the past three years 88 patients of neonatal tetanus were admitted to the Children's Hospital, PIMS, out of which we were able to save sixty eight. Advanced and sophisticated techniques like intermittent positive pressure ventilation and endotracheal intubation helped to save patients who would probably have died if these facilities were not available. These measures are not available in most of the hospitals in a poor country like Pakistan. It is felt that, under the circumstances, a preventive programme consisting of immunization of women of child bearing age would be a more practicable and cost effective solution